20 Sunday, 13 June 2004. Poster Display ... The probability of survival for such pts was estimated by Kaplan ... pare survival curves of ChCM and non-ChCM pts.
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Sunday, 13 June 2004
heart rate regulation and physical capacity in patients 6 months after PTCA.
79 Clinical course of patients with end-stage Chagas' cardiomyopathy on the waiting list for heart transplantation. R. Bestetti 1, T. Assad2, G. Carvalho 2, D. Villafanha 2
1Centro Universitdrio BarSo de Maud, Internal Medicine, RibeirSo Preto, Brazil; 2FAMERP, Cardiology, S8o Jos~ do Rio Preto, Brazil The prognosis of patients (pts) with heart failure due to Chagas cardiomyopathy (ChCM) is worse than that of pts with non-ChCM. However, outcome of patients with advanced forms of ChCM is unknown. Since the prognosis after heart transplantation (Ht) seems to be better for ChCM pts than for non-ChCM pts in spite of Trypanosoma cruz± infection reactivation, it would be important to know the prognosis of pts with advanced ChCM. Accordingly, the aim of this study was to report the outcome of ChCM pts with end-stage heart failure (ESHF) on the waiting list for Ht. From August, 2000 to December, 2003, 53 consecutive pts with ESHF prospectively followed at our institution were listed for Ht. All pts were given diuretics, digoxin, spironolactone, angiotensin converting enzyme inhibitor at maximal tolerated dose and carvedilol, when tolerated. The probability of survival for such pts was estimated by Kaplan Meir curves, whereas the Log rank-test was used to compare survival curves of ChCM and non-ChCM pts. Mean age was 40 ± 11 years, 41 (77%) pts were male. Twenty five (47%) pts had ChCM. Mean time on the waiting list was 80 4- 111 days. Twenty patients (39%) died, 30 [12 (56%)ChCM pts and 18 (66%) non-ChCM pts] underwent Ht and 3 (2 ChCM and 1 non-ChCM pt) were removed from the waiting list because of clinical improvement. Mean age was 39 ± 12 years in ChCM and 42 ± 11 years in non-ChCM pts (p>0.05), the proportion of male sex was 19/25 in ChCM pts and 22•28 in non-ChCM pts (p>0.05),15/25 ChCM pts and 16/28 non-ChCM pts (p>0.05)developed cardiogenic shock before HT, mean plasma sodium levels was 135 ± 6.1 mEq/1 in ChCM pts and 136 ± 7 mEq/1 in non-ChCM pts (p>0.05), left ventricular ejection fraction was 14 ± 5% in ChCM pts and 14 ± 5% in non-ChCM pts (p>0.05)and the proportion of exercise intolerance, available on 26 pts, was 10/14 in ChCM pts and 9/12 in non-ChCM pts (p>0.05). Eleven (47%) of 23 ChCM pts and 9 (33%) of 27 nonChCM pts died during the study period (p>0.05). Probability of survival at 180 days and 360 days on the waiting list was 16% and 2%, respectively, for CHCM pts and 16% and 5%, respectively,for non-ChCM pts (p=0.70; hazard ratio=0.96 (Confidence Interval 0.54 to 1,70). Thus, pts with ESHF due to ChCM have a poor clinical course and should be transplanted despite the potential for T. cruz± infection reactivation during follow up.Ix
80 Significance of the imbalance of Thl/Th2 function after acute myocardial infarction. X. Cheng, Y.H. Liao, H.X. Ge, B. Li, Z.Q. Gut, L. Zhang
Xiehe Hospital, Institute of Cardiovascular Disease, Wuhan, China Objective: Recently, the onset of acute myocardial infarction (AMI) and the ventricular remodeling after AMI have shown to be associated with inflammation. The study explored the significance of the imbalance of Thl/Th2 function after acute myocardial infarction. Methods: Peripheral blood mononuclear cells from 33 AMI patients, 22 unstable angina (UA) patients mad splenocytes from 35 AMI rats were collected. Cytokine-producing Th cells were ambulatory monitored by 3-color flow cytometry after stimulated with phorbol myristate acetate (PMA) and ionomycin. IFN-garnma and IL-4 mRNA in the rat myocardium and chemokine receptors CCR3,CCR5 and CXCR3 mRNA on the surface of rat T lymphocytes after AMI were measured by RT-PCR method. Results: Thl associated cytokine-IFN-gamma significantly increased in patients with AMI (22.4:k7.8%)and UA(20.6-4-6.4%) within 24 hours af-
Poster Display L Myocardial function, other ter the onset of symptom. The high ratio of 1FN-gamma-producing T cells lasted short in patients with UA and recovered 1 week (11.7±4.1%) after the onset. In AMI patients, the high ratio of IFN-gamma-producing T cells could be examined 1 week (17.1±6.0%) and even 1 month (15.1±4.8%) after the onset. There was no significant difference on the frequencies of IL-4-producing peripheral T cells between each group. 1 week(MI area 0.77±0.18 and Non-MI area 0.75±0.21 vs Sham group 0.31±0.08, P
